I hadn't been taking folic acid when I found out I was pregnant: risks, solutions and ways forward

Hola! Here goes a personal story around becoming pregnant and not following the advice on taking folic acid before conceiving.

If you are reading this, you may relate to this story and may want to find out if you and your baby at are high risk, if there's a solution or basically, what to do now. I hope you find a little bit more clarity after reading this.

I cannot sugar coat it: YOU ARE AT RISK as the foeuts develops rapidly nerve cells in the first weeks after conceiving. But, the degree of risk will depend on factors like:

• Your usual diet

• Your nutritional status, particularly your BMI (you are at higher risk if your BMI is above 30 kg/m2)

• History of neural tube deffects

• Any conditions that may affect absorption of folic acid (i.e., T1 and T2 Diabetes Mellitus, seizure disorders, coealic disease, sickle cell anaemia, irritable bowel disease)

For instance, when I decided to "try" having a baby, I felt in many ways (i.e., physically, emotionally and mentally) at my best. But it wasn't a decision that I had been thinking about for months so as to start taking the 400 mcg of folic acid that is advised to have 3 months in advance before you conceive. I actually remember going to the supermarket feeling really responsible as a nutritionist buying the folic acid supplements because I was now trying to become pregnant.

The reality was that I was part of the following statistic:

1/3 of fertile couples will conceive within the first month of trying. So by the time I started to take the folic acid, I was already pregnant. The issue -and this is why the risks is still prevalent- is that:

It takes 12 weeks to reach the recommended concentration of folic acid in the body to perform its functions for fetal development of the brain and spinal cord.

Therefore by taking this supplement, you are entering pregnancy with the desired levels of folic acid.

It is important to note that, your folic acid levels may not be so low when you become pregnant even if you haven't taken a supplement. Many food products contain "folate" (which is the natural form of the vitamin B9, whereas "folic acid" is the synthetic version).  

Folate rich foods include:

• Spinach, kale, brussels sprouts, cabbage, broccoli

• Beans and legumes (e.g. chickpeas, lentils, blackeye beans, kidney beans)

• Fortified foods (e.g. some breakfast cereals)

• Seeds and nuts

• Yeast extracts

• Oranges and orange juice

• Wheat bran and other wholegrain foods

• Eggs

• Poultry and pork

Certain countries (sadly not the UK yet) fortify flour with folic acid to reduce risks of neural tube deffects in pregnancies.

As you can see, there are many foods that contain folate (folic acid), so if your diet has been varied and balanced throughout the months prior to conception, then the risk of neural tube deffect could be lower.

The best recommendations I could leave you with is:

1. Start taking a 400 mcg supplement of folic acid if you haven't started yet

2. Call your GP practice or doctor to let them know you are pregnant. If you are in the UK, your midwife will give you a call and ask you some questions (including if you are taking folic acid or not)

3. Let your Midwife or other healthcare practitioner if you are worried or have any of the mentioned conditions that could affect your absorption of folic acid as they may advice and prescribe you to take a higher dose.

4. DO NOT TAKE more folic acid if you haven't been prescribed a higher dose (it is not a matter of "compensating", as higher doses could be harmful).

5. Mantain a balanced and varied diet, this is a win-win for you and your baby.